A decade-long review: insights into diagnosis and disease evolution of uveitis from a single-center study.

PURPOSE: To analyse the evolution of uveitis diagnosis over a 10-year period, emphasizing the change in etiological diagnosis, and the factors associated with recurrences.

DESIGN

Retrospective chart review.

METHODS

A total of 15,000 patients with uveitis presented at our tertiary care institute in North India between 1992 and 2023. Of these,123 patients completed 10-year follow-up and were included in the study. The data of patients was collected on an offline purpose-built uveitis registry portal: Ocular Autoimmune Systemic Inflammatory and Infectious Study(OASIS).

RESULTS

The study included 123 patients (48.78% males; mean age: 29.11 ± 15.22 years). The most common anatomical and etiological diagnosis at presentation were anterior (49/123,34.96%) and idiopathic(59/123,47.97%) uveitis respectively. At the end of 10 years, anterior uveitis remained the most common anatomical diagnosis (43/123,39.83%) while the most common etiological diagnosis was immune-mediated uveitis (50/123,40.65%). An etiological diagnosis could be established in 50.85% (30/59) of patients initially labelled as idiopathic. Tuberculous uveitis (39/44, 88.63%) and Juvenile Idiopathic Arthritis associated uveitis (16/49, 32.65%) were the commonest infectious and immune-mediated aetiologies at the 10-year follow-up. Ninety-six (80.67%) patients experienced multiple episodes of ocular inflammation with a mean recurrence rate of 0.386 ± 0.24 recurrences/year. Anterior uveitis (p = 0.01), the change in etiological diagnosis after the first year (p = 0.03), positive HLA-B27 at baseline (p = 0.04), and the diagnosis of a systemic disease prior to the onset of uveitis were associated with higher recurrences rates (p = 0.03).

CONCLUSION

Over 10-year of follow-up, half of the uveitis diagnoses evolved from idiopathic to specific infectious or immune-mediated aetiologies. Our results indicate that patients with a high recurrence rate may benefit from re-evaluation to find the definitive cause of uveitis.